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. 2012 Feb;153(2):370-378.e2.
doi: 10.1016/j.ajo.2011.06.028. Epub 2011 Sep 14.

Depression and visual functioning in patients with ocular inflammatory disease

Ying Qian  1 , Tanya Glaser, Elizabeth Esterberg, Nisha R Acharya
Affiliations

Depression and visual functioning in patients with ocular inflammatory disease

Ying Qian et al. Am J Ophthalmol. 2012 Feb.

Abstract

Purpose: To characterize the level of depression in patients with ocular inflammatory disease and to determine predictors of depression in this population.

Design: Prospective cross-sectional survey and medical record review.

Methods: Participants were consecutive patients with noninfectious ocular inflammatory disease in a university-based tertiary referral center. Subjects were given the self-administered Beck Depression Inventory-II (BDI-II), National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25), and additional supplemental questions. Medical records were reviewed for clinical characteristics. Univariate analyses were conducted to compare clinical characteristics between patients with and without a positive screen for depression, and a multivariate regression model was performed to determine the most significant predictors of depression.

Results: Of the 104 participants, 26.9% screened positive for depression with the BDI-II. Of these subjects, only 39.3% had been previously diagnosed with depression. NEI VFQ-25 scores were significantly lower in depressed patients in all subscales except driving and color vision. Predictors of depression were inadequate emotional support, lower visual functioning (VFQ composite score), history of changing immunomodulatory treatment, and current oral corticosteroid use.

Conclusions: Depression may be a significant but underrecognized comorbid condition in patients with ocular inflammatory disease. Worse visual function was associated with depression. The authors recommend heightened awareness of potential depression in patients with ocular inflammatory disease.

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Figures

FIGURE 1
FIGURE 1
Distribution of Beck Depression Inventory II (BDI-II) scores among 104 patients with ocular inflammatory disease. Scores of 0–13 represent no depression, 14–19 mild depression, 20–28 moderate depression and 29 and over severe depression. Dashed lines represent the mean BDI-II scores within each depression category. Shaded areas represent patients who had self-reported diagnoses of clinical depression.
FIGURE 2
FIGURE 2
Correlation between Beck Depression Inventory II (BDI-II) score and National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) score in patients with ocular inflammatory disease. Dashed line represents the cutoff BDI-II score of 13 between the negative and positive screen. A Pearson correlation of −0.53 represents a moderate to strong inverse correlation (P < 0.001).
FIGURE 3
FIGURE 3
Correlation between best corrected visual acuity (BCVA) in logMAR in the better seeing eye and National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) composite score in patients with ocular inflammatory disease. A Pearson correlation of −0.58 (P < 0.001) represents a moderate to strong inverse correlation.
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